Water Quality Assessment of Roof-collected Rainwater in Miri, Malaysia

2021 ◽  
Vol 1 (2) ◽  
pp. 87-97
Author(s):  
Joel Joseph Hughes Frichot ◽  
Rubiyatno ◽  
Gaurav Talukdar
Keyword(s):  
Heavy Metal ◽  
Physicochemical Parameters ◽  
Rainwater Harvesting ◽  
Cost Effective ◽  
Water Quality Assessment ◽  
Class I ◽  
Storage Tanks ◽  
Class Iii ◽  
Wet Season ◽  
Mean Concentration

Rainwater harvesting systems are becoming more acceptable as an alternative method to harvest water sources for both potable and non-potable uses. While the method has proven to be very simplistic and cost-effective, the collected rainwater source remains untreated and can pose serious health concerns if not used properly. This study focused on the physicochemical and heavy metal parameters of roof-collected rainwater in Miri, Sarawak. Individual sites were chosen throughout Miri, Sarawak for representative samples. Atomic Absorption Spectroscopy was used for the analysis of heavy metal concentrations. Heavy metal analysis included manganese, zinc, iron, copper, and cadmium. pH, temperature, turbidity, dissolved oxygen (DO), total suspended solids (TSS), total dissolved solids (TDS), nitrate, and fluoride were among the physicochemical parameters examined. Seasonal comparison indicated the majority of the higher concentration levels occurred during the wet season. The overall mean concentration for the physicochemical parameters indicated CLASS I usage, with the exception of BOD5, which was CLASS III usage. The overall mean concentration for metals analyzed indicated a CLASS I usage threshold with the exception of copper, which had concentrations well above the 0.02mg/L threshold for all sites. Thus, copper was considered one of the major contaminants for this study. Moreover, the types of storage tanks also showcased key findings. Open top storage tanks are more vulnerable to contamination than closed storage tanks. Metal storage tanks offer higher rainwater temperatures in comparison to other types of storage tanks. 

scholarly journals Telemonitoring Versus Usual Care for Elderly Patients With Heart Failure Discharged From the Hospital in the United States: Cost-Effectiveness Analysis (Preprint)

2020 ◽  
Author(s):  
Xinchan Jiang ◽  
Jiaqi Yao ◽  
Joyce HS You
Keyword(s):  
Heart Failure ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Usual Care ◽  
Nyha Class ◽  
Cost Effective ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Hospitalization Cost

BACKGROUND Telemonitoring-guided interventional management reduces the need for hospitalization and mortality of patients with chronic heart failure (CHF). OBJECTIVE This study aimed to analyze the cost-effectiveness of usual care with and without telemonitoring-guided management in patients with CHF discharged from the hospital, from the perspective of US health care providers. METHODS A lifelong Markov model was designed to estimate outcomes of (1) usual care alone for all postdischarge patients with CHF (New York Heart Association [NYHA] class I-IV), (2) usual care and telemonitoring for all postdischarge patients with CHF, (3) usual care for all postdischarge patients with CHF and telemonitoring for patients with NYHA class III to IV, and (4) usual care for all postdischarge patients with CHF plus telemonitoring for patients with NYHA class II to IV. Model inputs were derived from the literature and public data. Sensitivity analyses were conducted to assess the robustness of model. The primary outcomes were total direct medical cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). RESULTS In the base case analysis, universal telemonitoring group gained the highest QALYs (6.2967 QALYs), followed by the telemonitoring for NYHA class II to IV group (6.2960 QALYs), the telemonitoring for NYHA class III to IV group (6.2450 QALYs), and the universal usual care group (6.1530 QALYs). ICERs of the telemonitoring for NYHA class III to IV group (US $35,393 per QALY) and the telemonitoring for NYHA class II to IV group (US $38,261 per QALY) were lower than the ICER of the universal telemonitoring group (US $100,458 per QALY). One-way sensitivity analysis identified five critical parameters: odds ratio of hospitalization for telemonitoring versus usual care, hazard ratio of all-cause mortality for telemonitoring versus usual care, CHF hospitalization cost and monthly outpatient costs for NYHA class I, and CHF hospitalization cost for NYHA class II. In probabilistic sensitivity analysis, probabilities of the universal telemonitoring, telemonitoring for NYHA class II to IV, telemonitoring for NYHA class III to IV, and universal usual care groups to be accepted as cost-effective at US $50,000 per QALY were 2.76%, 76.31%, 18.6%, and 2.33%, respectively. CONCLUSIONS Usual care for all discharged patients with CHF plus telemonitoring-guided management for NYHA class II to IV patients appears to be the preferred cost-effective strategy.

scholarly journals Analisis Keefektifan Biaya Pengobatan Pada Pasien Pneumonia Balita Di Instalasi Rawat Inap Rumah Sakit Paru Dr. Ario Wirawan Salatiga Tahun 2018

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Nita Tanti Wulandari ◽  
Ening Listyanti ◽  
Niken Dyahariesti ◽  
Agitya Resti Erwiyani
Keyword(s):  
Antibiotic Therapy ◽  
Evaluation Method ◽  
Acute Infection ◽  
Cost Effective ◽  
Class Ii ◽  
Class I ◽  
Therapeutic Effects ◽  
Class Iii ◽  
Medical Expenses ◽  
Selection Of

Pneumonia adalah infeksi akut yang menyerang jaringan paru-paru yang disebabkan oleh bakteri, virus maupun jamur. Pengobatan pneumonia yang diterapi dengan antibiotik secara efektif dapat meningkatkan efek terapeutik klinis, meminimalkan toksisitas obat mengurangi angka kejadian resistensi dan lebih ekonomis. CEA merupakan suatu metode evaluasi ekonomi yang dapat digunakan dalam mengambil keputusan pemilihan alternatif terbaik pada pemilihan biaya pengobatan pneumonia. Penelitian ini bertujuan  untuk menganalisis keefektifan biaya pengobatan pada pasien pneumonia balita di rawat inap Rumah Sakit Paru dr. Ario Wirawan Salatiga   tahun 2018. Penelitian ini menggunakan merupakan penelitian non eksperimental (observasional) menggunakan pendekatan retrospektif dan dianalisis secara deskriptif. Sampel yang digunakan sebanyak 30 pasien. Sampel dianalisis sesuai dengan metode ACER dan ICER. Efektivitas terapi dilihat dari LOS. Nilai ACER: kelas VIP: Ceftriaxon + Cefixime Rp. 615.177, Cefotaxime + Gentamisin Rp.810.773.  Kelas I: Cefotaxime + Gentamisin Rp. 536.880. Kelas II: Cefotaxime Rp. 408.493, Cefotaxime + Cefixime Rp. 357.397, Cefotaxime + Gentamisin Rp. 385.488 dan Ceftriaxon + Cefixime  Rp. 325.355. Kelas III: Cefotaxime Rp. 278.740, Ceftriaxon Rp. 186.250, Cefotaxime + Gentamisin Rp. 312.734, Cefotaxime + Cefixime Rp.286.128 dan Ceftriaxon + Cefixime Rp.295.100. Nilai ICER pada kelas VIP : Ceftriaxon + Cefixime dan Cefotaxime + Gentamisin Rp. -356.967 dan pada kelas III adalah Ceftriaxon dan Cefotaxime Rp.-91.219. Pada pengobatan bronkopneumonia balita terapi antibiotik yang paling cost-effective di ruang kelas VIP adalah penggunaan antibiotik kombinasi Ceftriaxon + Cefixime, ruang kelas I adalah Cefotaxime + Gentamisin, ruang kelas II adalah Cefotaxime, dan ruang kelas III adalah Cefotaxime.Kata Kunci           : Analisis Keefektifan Biaya, Terapi Antibiotik, PneumoniaPneumonia is an acute infection that attacks lung tissue caused by bacteria, viruses and fungi. Treatment of pneumonia is effectively treated with antibiotics because it can increase clinical therapeutic effects, minimizing drug toxicity reduces the incidence of resistance and more economical. CEA is an economic evaluation method that can be used in making the best decision on the selection of alternatives in the selection of pneumonia treatment costs. To analyze the effectiveness of medical expenses in pneumonia patients under five inpatient hospitalized Dr. Ario Wirawan Salatiga in 2018. This study used a non-experimental (observational) method using a retrospective approach and analyzed descriptively. The sample used was 30 patients. The samples were analyzed according to the ACER and ICER methods. The effectiveness of therapy was seen from LOS. ACER Value: VIP class: Ceftriaxon + Cefixime Rp. 615,177, Cefotaxime + Gentamisin Rp.810,773. Class I: Cefotaxime + Gentamisin Rp. 536,880. Class II: Cefotaxime Rp. 408,493, Cefotaxime + Cefixime Rp. 357,397, Cefotaxime + Gentamisin Rp. 385,488 and Ceftriaxon + Cefixime Rp. 325,355. Class III: Cefotaxime Rp.278,740, Ceftriaxon Rp.186,250, Cefotaxime + Gentamisin Rp. 312,734, Cefotaxime + Cefixime Rp.286,128 and Ceftriaxon + Cefixime Rp.295.100. ICER scores at VIP class: Ceftriaxon + Cefixime and Cefotaxime + Gentamisin Rp. -356,967 and in class III Ceftriaxon and Cefotaxime Rp.-91,219. In bronchopneumonia treatment toddlers the most cost-effective antibiotic therapy in VIP classrooms is the use of a combination antibiotic Ceftriaxon + Cefixime, class I is Cefotaxime + Gentamisin, Class II is Cefotaxime, and Class III is Cefotaxime.Keywords : Cost Effectiveness Analysis, Antibiotic Therapy, Pneumonia

scholarly journals Telemonitoring Versus Usual Care for Elderly Patients With Heart Failure Discharged From the Hospital in the United States: Cost-Effectiveness Analysis

10.2196/17846 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17846
Author(s):  
Xinchan Jiang ◽  
Jiaqi Yao ◽  
Joyce HS You
Keyword(s):  
Heart Failure ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Usual Care ◽  
Nyha Class ◽  
Cost Effective ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Hospitalization Cost

Background Telemonitoring-guided interventional management reduces the need for hospitalization and mortality of patients with chronic heart failure (CHF). Objective This study aimed to analyze the cost-effectiveness of usual care with and without telemonitoring-guided management in patients with CHF discharged from the hospital, from the perspective of US health care providers. Methods A lifelong Markov model was designed to estimate outcomes of (1) usual care alone for all postdischarge patients with CHF (New York Heart Association [NYHA] class I-IV), (2) usual care and telemonitoring for all postdischarge patients with CHF, (3) usual care for all postdischarge patients with CHF and telemonitoring for patients with NYHA class III to IV, and (4) usual care for all postdischarge patients with CHF plus telemonitoring for patients with NYHA class II to IV. Model inputs were derived from the literature and public data. Sensitivity analyses were conducted to assess the robustness of model. The primary outcomes were total direct medical cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Results In the base case analysis, universal telemonitoring group gained the highest QALYs (6.2967 QALYs), followed by the telemonitoring for NYHA class II to IV group (6.2960 QALYs), the telemonitoring for NYHA class III to IV group (6.2450 QALYs), and the universal usual care group (6.1530 QALYs). ICERs of the telemonitoring for NYHA class III to IV group (US $35,393 per QALY) and the telemonitoring for NYHA class II to IV group (US $38,261 per QALY) were lower than the ICER of the universal telemonitoring group (US $100,458 per QALY). One-way sensitivity analysis identified five critical parameters: odds ratio of hospitalization for telemonitoring versus usual care, hazard ratio of all-cause mortality for telemonitoring versus usual care, CHF hospitalization cost and monthly outpatient costs for NYHA class I, and CHF hospitalization cost for NYHA class II. In probabilistic sensitivity analysis, probabilities of the universal telemonitoring, telemonitoring for NYHA class II to IV, telemonitoring for NYHA class III to IV, and universal usual care groups to be accepted as cost-effective at US $50,000 per QALY were 2.76%, 76.31%, 18.6%, and 2.33%, respectively. Conclusions Usual care for all discharged patients with CHF plus telemonitoring-guided management for NYHA class II to IV patients appears to be the preferred cost-effective strategy.

Chemometric Analysis of Substituent Effects. VIII. Alternative Interpretation of Substituent Effects (AISE)

1995 ◽  
Vol 60 (9) ◽  
pp. 1502-1528 ◽  
Author(s):  
Oldřich Pytela
Keyword(s):  
Multiple Bond ◽  
Substituent Effects ◽  
Alternative Interpretation ◽  
Class I ◽  
Reaction Centre ◽  
Correlation Equations ◽  
Class Iii ◽  
Substituent Constant ◽  
Chemical Models ◽  
The Individual

Alternative interpretation of substituent effects (AISE) starts from the presumption that a substituent only possesses a single property described by a single substituent constant. This property is transmitted to the reaction centre by three different ways depending on the interaction type in the triad reaction centre - basic skeleton - substituent. For interpretation it is substantial whether or not the substituent has p electrons at the atom adjacent to the basic skeleton. If it has none, the substituent belongs to class I and operates only by its basic effect described by the mentioned single substituent constant. Substituents of class II possess a free electron pair at the atom adjacent to the basic skeleton, and those of class III have a multiple bond between the first and the second atoms which is polarized in the direction from the basic skeleton. Substituent effects in class I are described by a substituent constant identical with σI constant. Substituents in classes II and III show additional effects proportional to the same constant. Hence, a separate treatment of substituent effects in the individual classes provides three straight lines intersecting in a common point. Mathematically, the description of substituent effects in this approach is expressed by a family of lines with a single explaining variable. The point of intersection, which is referred to as the iso-effect point, is not identical with the classic standard substituent - hydrogen - but is near to CN substituent. The approach given has the advantage of adopting a single substituent constant whose scale can be adjusted relatively precisely. Its drawback (like in the case of the correlation equations derived from the principle of separation of substituent effects) lies in a more extensive set of substituents needed for a correlation. The AISE principle has been applied to 318 series of experimental data describing effects of 32 substituents in a large variety of chemical models (aliphatic, alicyclic, aromatic, heteroaromatic, with or without direct conjugation between reaction centre and substituent) in both chemical reactions and equilibria. A comparison with two other correlation relations with two and three substituent constants for interpretation of substituent effects based on the principle of separation of the individual substituent effects showed that the closeness of AISE based correlations is comparable with that of the correlation equations currently used. It was somewhat less successful in the models with direct conjugation between reaction centre and substituent but the AISE principle can be used even in these cases.

scholarly journals Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 413
Author(s):  
Hui-Ling Chen ◽  
Jason Chen-Chieh Fang ◽  
Chia-Jung Chang ◽  
Ti-Feng Wu ◽  
I-Kuan Wang ◽  
...  
Keyword(s):  
Cadmium Concentration ◽  
Class Ii ◽  
Cadmium Exposure ◽  
Class I ◽  
P Value ◽  
Tooth Decay ◽  
Class Iii ◽  
Orthodontic Patients ◽  
Urine Cadmium ◽  
The Mean

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

scholarly journals Removal of heavy metal ions from wastewater: a comprehensive and critical review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Naef A. A. Qasem ◽  
Ramy H. Mohammed ◽  
Dahiru U. Lawal
Keyword(s):  
Heavy Metal ◽  
Metal Ions ◽  
Large Volume ◽  
Heavy Metal Ions ◽  
Membrane Separation ◽  
Cost Effective ◽  
Operating Conditions ◽  
Future Research ◽  
Sludge Formation ◽  
Metals Removal

AbstractRemoval of heavy metal ions from wastewater is of prime importance for a clean environment and human health. Different reported methods were devoted to heavy metal ions removal from various wastewater sources. These methods could be classified into adsorption-, membrane-, chemical-, electric-, and photocatalytic-based treatments. This paper comprehensively and critically reviews and discusses these methods in terms of used agents/adsorbents, removal efficiency, operating conditions, and the pros and cons of each method. Besides, the key findings of the previous studies reported in the literature are summarized. Generally, it is noticed that most of the recent studies have focused on adsorption techniques. The major obstacles of the adsorption methods are the ability to remove different ion types concurrently, high retention time, and cycling stability of adsorbents. Even though the chemical and membrane methods are practical, the large-volume sludge formation and post-treatment requirements are vital issues that need to be solved for chemical techniques. Fouling and scaling inhibition could lead to further improvement in membrane separation. However, pre-treatment and periodic cleaning of membranes incur additional costs. Electrical-based methods were also reported to be efficient; however, industrial-scale separation is needed in addition to tackling the issue of large-volume sludge formation. Electric- and photocatalytic-based methods are still less mature. More attention should be drawn to using real wastewaters rather than synthetic ones when investigating heavy metals removal. Future research studies should focus on eco-friendly, cost-effective, and sustainable materials and methods.

scholarly journals Optimal Sizing of Rooftop Rainwater Harvesting Tanks for Sustainable Domestic Water Use in the West Bank, Palestine

Water ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 573
Author(s):  
Sameer Shadeed ◽  
Sandy Alawna
Keyword(s):  
Storage Tank ◽  
Rainwater Harvesting ◽  
West Bank ◽  
Family Members ◽  
Optimal Size ◽  
Storage Tanks ◽  
Domestic Water ◽  
The West ◽  
Average Family ◽  
Rooftop Rainwater Harvesting

In highly water-poor areas, rooftop rainwater harvesting (RRWH) can be used for a self-sustaining and self-reliant domestic water supply. The designing of an optimal RRWH storage tank is a key parameter to implement a reliable RRWH system. In this study, the optimal size of RRWH storage tanks in the different West Bank governorates was estimated based on monthly (all governorates) and daily (i.e., Nablus) inflow (RRWH) and outflow (domestic water demand, DWD) data. In the estimation of RRWH, five rooftop areas varying between 100 m2 and 300 m2 were selected. Moreover, the reliability of the adopting RRWH system in the different West Bank governorates was tested. Two-time series scenarios were assumed: Scenario 1, S1 (12 months, annual) and scenario 2, S2 (8 months, rainy). As a result, reliable curves for preliminary estimation of optimal RRWH storage tanks for the different West Bank governorates were obtained. Results show that the required storage tank for S1 (annual) is more than that of the S2 (rainy) one. The required storage tank to fulfill DWD is based on the average rooftop area of 150 m2, the average family members of 4.8, and the average DWD of 90 L per capita per day (L/c/d) varies between (75 m3 to 136 m3) and (24 m3 to 84 m3) for S2 for the different West Bank governorates. Further, it is found that the optimal RRWH tank size for the 150 m2 rooftop ranges between 20 m3 (in Jericho) to 75 m3 (in Salfit and Nablus) and between 20 m3 (in Jericho) to 51 m3 (in Jerusalem) for S1 and S2 scenarios, respectively. Finally, results show that the implementation of an RRWH system for a rooftop area of 150 m2 and family members of 4.8 is reliable for all of the West Bank governorates except Jericho. Whereas, the reliability doesn’t exceed 19% for the two scenarios. However, the reduction of DWDv is highly affecting the reliability of adopting RRWH systems in Jericho (the least rainfall governorate). For instance, a family DWDv of 3.2 m3/month (25% of the average family DWDv in the West Bank) will increase the reliability at a rooftop area of 150 m2 to 51% and 76% for S1 and S2, respectively.

Reduced Efficacy of the Pipeline Embolization Device in the Treatment of Posterior Communicating Region Aneurysms with Fetal Posterior Cerebral Artery Configuration

Neurosurgery ◽  
2017 ◽  
Vol 82 (5) ◽  
pp. 695-700 ◽  
Author(s):  
Anil K Roy ◽  
Brian M Howard ◽  
Diogo C Haussen ◽  
Joshua W Osbun ◽  
Sameer H Halani ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Clinical Symptoms ◽  
Posterior Cerebral Artery ◽  
Neurological Complications ◽  
Class I ◽  
Class Iii ◽  
Pipeline Embolization Device ◽  
Independent Association ◽  
Incomplete Occlusion

Abstract BACKGROUND Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed. Demographics, treatment details, and imaging were reviewed for all PcommA and fPCA aneurysms. RESULTS Out of a total of 285 patients treated with PED, 50 patients (mean age 57.5 ± 12.2 yr, 42 females) with unruptured PcommA (9 fPCA) aneurysms were identified. Mean follow-up duration was 14.0 ± 11.6 mo (48 patients). Roy-Raymond class I occlusion on follow-up magnetic resonance or catheter angiography (mean time 11.7 ± 6.8 mo) was achieved in 30 patients (62.5%), class II occlusion in 11 patients (22.9%) and class III occlusion in 7 patients (14.5%). The PcommA was occluded in 56% of patients without any clinical symptoms. No deaths or permanent neurological complications occurred. In fPCA aneurysms, class I occlusion was seen in 1 patient, class 2 occlusion in 2 patients, and class III occlusion in 6 patients. Multivariate analysis revealed an independent association between incomplete occlusion and fPCA configuration (OR 73.65; 95% CI: 5.84-929.13; P = .001). CONCLUSION The PED is a safe and effective treatment for PcommA aneurysms, although fetal anatomy should increase consideration of traditional endovascular techniques or surgical clipping.

Effects of antiarrhythmic drugs on atrioventricular conduction in patients with preexisting bundle branch block

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Kochav ◽  
R.C Chen ◽  
J.M.D Dizon ◽  
J.A.R Reiffel
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Class I ◽  
Class Iii ◽  
Bundle Branch Block ◽  
Kaplan Meier ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
History Of ◽  
Propensity Score Stratification

Abstract Background Theoretical concern exists regarding AV block (AVB) with class I antiarrhythmics (AADs) when bundle branch block (BBB) is present. Whether this is substantiated in real-world populations is unknown. Purpose To determine the relationship between type of AAD and incidence of AVB in patients with preexisting BBB. Methods We retrospectively studied all patients with BBB who received class I and III AADs between 1997–2019 to compare incidence of AVB. We defined index time as first exposure to either drug class and excluded patients with prior AVB or exposed to both classes. Time-at-risk window ended at first outcome occurrence or when patients were no longer observed in the database. We estimated hazard ratios for incident AVB using Cox proportional hazards models with propensity score stratification, adjusting for over 32,000 covariates from the electronic health record. Kaplan-Meier methods were used to determine treatment effects over time. Results Of 40,120 individuals with BBB, 148 were exposed to a class I AAD and 2401 to a class III AAD. Over nearly 4,200 person-years of follow up, there were 22 and 620 outcome events in the class I and class III cohorts, respectively (Figure). In adjusted analyses, AVB risk was markedly lower in patients exposed to class I AADs compared with class III (HR 0.48 [95% CI 0.30–0.75]). Conclusion Among patients with BBB, exposure to class III AADs was strongly associated with greater risk of incident AVB. This likely reflects differences in natural history of patients receiving class I vs class III AADs rather than adverse class III effects, however, the lack of worse outcomes acutely with class I AADs suggests that they may be safer in BBB than suspected. Funding Acknowledgement Type of funding source: None

scholarly journals SATELLITE DNAs IN THE EMBRYOS OF VARIOUS SPECIES OF THE GENUS DROSOPHILA

Genetics ◽  
1972 ◽  
Vol 72 (3) ◽  
pp. 431-439
Author(s):  
E C Travaglini ◽  
J Petrovic ◽  
J Schultz
Keyword(s):  
Buoyant Density ◽  
Gc Content ◽  
Drosophila Species ◽  
Class I ◽  
Evolutionary Divergence ◽  
Dna Molecules ◽  
Class Iii ◽  
Satellite Dnas ◽  
Evolutionary Pattern ◽  
Gc Composition

ABSTRACT A tentative evolutionary pattern has been found for two classes of the multiple satellite DNA's found in the genus Drosophila. The satellite DNA's from five Drosophila species (D. melanogaster, D. simulans, D. nasuta, D. virilis and D. hydei) were analyzed and found to fall into three arbitrary CsCl buoyant density classes: Class I, ρ = 1.661-1.669 g cm-3, DNA molecules composed of primarily dA and dT moieties; Class II, ρ = 1.685 and ρ = 1.692, DNA molecules of low GC content; and Class III, ρ = 1.711, a DNA of high GC composition. The dAT satellite DNA's appear in all the species studied except D. hydei, the species of most recent evolutionary divergence, whereas the heavy satellite appears only in the two species of most recent divergence, D. virilis and D. hydei.

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